School Nurse Recommendations
We understand that vision screenings are a big challenge for school nurses. There are always more and more students and therefore less and less time to conduct screenings. Recent national statistics question the effectiveness of school vision screenings and their ability to channel families toward professional, follow-up care.
However, as Connecticut optometrists visit with local school nurses, it is not surprising to find that they are doing an excellent job. Unfortunately, there are inherent limitations to vision screenings since screeners do not have the time or resources necessary to detect many “hard to find” vision problems such as farsightedness (ability to see up close), focusing deficencies and poor eye coordination .
For this reason, it is important for vision screeners to carefully make parents and teachers aware of the limitations of their screenings, and to not rule out a learning-related vision problem even if a child has passed a screening. In an effort to help, the Connecticut Association of Optometrsts recommends that the following additional screening procedures be adopted by school nurses as part of their vision screening program.
- Add Plus Lens Test: to evaluate farsightedness
- Add Steropsis Test: to evaluate Amblyopia, eye turns and eye coordination
- Add Observational Checklist for parents/teachers: to evaluate students who are not performing as expected
These tests cost approximately $170 and add about 40 seconds to each screening. To order these tests contact Bernell at www.bernell.com or 800-348-2225.
The tests are simple to administer. Please read on for step-by-step instructions.
Plus Lens Testing
Purpose: A screening procedure to help detect farsightedness (ability to see close-up).
Equipment Needed:
- Visual acuity chart, positioned in well lighted area
- Occluder or 3x5 card
- +1.50 lenses(order from Bernell at www.bernell.com – $15)
Procedure:
1. First perform regular visual acuity test. Student stands at appropriate distance from chart based on calibration.
2. Student covers the left eye with the occluder or card.Be sure he/she is not peeking or pressing on eye.
3. Instructions: “Call out the smallest row of letters you can. Don’t squint or peek around the cover.” It is helpful to memorize the lines of letters so that you can watch the student during testing rather than the chart.
4. Record the smallest row for which the student correctly identifies at least half of the letters.
5. Repeat for the other eye.
6. Repeat with both eyes together.
7. Now perform the Plus Lens Test: Have student hold +1.50 lenses in front of both eyes (see photo).
8. Instructions: “Call out the smallest row of letters you can.Remember not to squint.”
Expected Findings: A student who is not farsighted will have blurry vision when looking through the +1.50 lenses. 
